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卵巢過度刺激症的中醫療法病案報告

Traditional Chinese Medicine Treatment of Ovarian Hyperstimulation Syndrome-A Case Report

摘要


卵巢過度刺激症是人工生殖療程最嚴重的併發症之一。由於人工生殖與促進排卵藥物的使用在晚近20年才趨於成熟,並大量運用在不孕症婦女治療。中醫古籍從未記載此病症,且現代中醫治療卵巢過度刺激症的病例仍不多。本病案提出中醫治療一卵巢過度刺激症的36歲孕婦,在接受試管嬰兒療程後,出現嚴重的腹水、體重上升、胸悶喘促、胃脹及噁心感。採用中藥治療以清熱涼血配合瀉利水邪治法,再配合密集的針刺及草藥薰蒸,經過一個星期後胸悶與腹脹感即明顯減少,而且在30天的治療中腹水與體重均穩定下降,D雙合蛋白(D-Dimer)指數更從1400降至260(μg/ml)。藉由中醫早期介入治療卵巢過度刺激症可即時緩解腹水蓄積與胸悶喘促等不適,是治療婦產科急症可考慮採取的治療模式之一。

並列摘要


Ovarian hyperstimulation syndrome (OHSS) is one of the most severe complications of fertility medication. Because Artificial fertilization technique was well-developed in last two decades, OHSS was never documented in ancient Chinese medicine books. Here we brief on the case of a 36 year-old pregnant women who presented intense Ascites, with weight gain, chest tightness, breathlessness, nausea and bloating.After one month TCM treatment using Long-Dan-Xie-Gan and Yin Chen Hao formulas, acupuncture, cupping, and herbal fumigation once daily, the ascites subsided and symptoms were relieved, also her D-dimer decreased from 1400 to 260 (μg/ml).TCM Day-Care-therapy can give an intensive treatment and follow up. Clinical doctor might considered a viable and acceptable treatment option for patients who suffer from severe disease.

參考文獻


Polishuk, WZ,Schenker, JG(1969).Ovarian overstimulation syndrome.Fertil. Steril..20,443-447.
Tulandi, T,McInnes, RA,Arronet, GH(1984).Ovarian hyperstimulation syndrome following ovulation induction with human menopausal gonadotropin.Int. J. Fertil..29,113-121.
Delvigne, A,Rozenberg, S(2002).Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review.Hum. Reprod. Update.8,559-572.
Navot, D,Bergh, PA,Palermo, R(1994).Pathophysiology and clinical management of ovarian hyperstimulation.International congress series.1046,319.
Engel, T,Jewelewicz, R,Dyrenfurth, I(1972).Ovarian hyperstimulation syndrome. Report of a case with notes on pathogenesis and treatment.Am. J. Obstet. Gynecol..112,1052-1063.

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